Abstract 3339: Cardiovascular Benefits of Wii-based Movement Therapy for Upper Limb Post-stroke Rehabilitation
Persistent motor disability limits the capacity of stroke patients to retain or regain physical fitness. Increased metabolic demands of hemiparetic gait, physical deconditioning, and secondary muscle changes including atrophy and a shift in muscle fibre phenotype, combine to reduce post-stroke aerobic capacity by ∼50%. Fitness may be overlooked in rehabilitation programs when primary goals are centred on speech and effective locomotion. In this study we investigated whether cardiovascular fitness could be improved using Wii-based movement therapy that specifically targets hand and upper limb function. We studied 15 male and 3 female patients with post-stroke hemiparesis, mean age 61.4 years (range 22-75 years), mean time post-stroke 21.7 months (range 5-91 months). All patients completed the 2 week program with one hour of formal therapy on 10 consecutive weekdays augmented by home practice using the standard Wii Sports games of baseball, bowling, boxing, golf and tennis. Heart rate was recorded continuously using wireless telemetry during formal therapy sessions at three time points: early, mid and late therapy. During the same sessions the number of steps during tennis and boxing was counted from video recordings. Functional ability was assessed before and after therapy using the Wolf Motor Function Test (WMFT) and the Motor Activity Log (MAL). Peak heart rate significantly increased from early to late therapy (p<0.001), becoming 38% higher on average than resting rates by late therapy. A sport-specific gradient was evident with increases in peak heart rate ranging from 20.9% in golf to 49.0% in boxing (p<0.001). A concomitant improvement in exercise endurance was also noted. These changes occurred despite most patients being treated with beta blockers and ace-inhibitors. Functional ability improved by 23% (WMFT, p=0.037) which transferred to everyday tasks with a 127% improvement (MAL) (both p<0.001). In conclusion these results suggest that Wii-based movement therapy not only improves upper limb function but also provides a cardiovascular challenge, mitigating the marked reduction in fitness commonly reported post-stroke. The differential effect on heart rate of the basic Wii Sports games provides a further avenue to tailor therapy for individual patients according for cardiac status and fitness levels.
- © 2012 by American Heart Association, Inc.